The National Transportation and Safety Board issued its 2014 Most Wanted List, which names their top ten priorities for improving transportation safety nationwide.

Last month, a Metro-North Railroad train plunged off the track while taking a sharp curve at 82 miles per hour, killing four and seriously injuring 20. In the aftermath, some experts said the disastrous results could have been prevented by positive train control (PTC). An automatic braking system built to slow down dangerous trains, PTC has been available since 1990. But the lifesaving tech remains widely unadopted.

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"The Metro-North accident claimed four lives," says Robert Sumwalt, a vice chairman at the National Transportation and Safety Board (NTSB). "We looked at the situation and said, had PTC been implemented, it would have prevented the accident, more than likely."

Positive train control is one 10 items on the NTSB's 2014 Most Wanted List, the organization's annual tally of its most important safety priorities. In fact, NTSB had already voted to include PTC before the Metro-North accident. The list also includes driver/operator distraction, pipeline safety, and more, with the aim of "drawing added attention to issue areas that we know can prevent accidents and save lives," Sumwalt says.

The Most Wanted List regularly featured PTC for almost 20 years until Congress passed the Rail Safety Improvement Act in 2008, which charged railroads to implement the new technology by 2015. But the Federal Railroad Administration (FRA) exempted about 10,000 miles of track from meeting this deadline in 2012. "We saw a lot of pushback from the rail industry," Sumwalt says. "So last year we added [PTC] back to the list."

Helicopter safety is another major addition to the 2014 Most Wanted List. Although the NTSB advocates improved safety standards for all rotorcraft, helicopter emergency medical services (HEMS) warranted specific mention. HEMS pilots "transport seriously ill patients and donor organs to emergency care facilities, often creating pressure to conduct these operations safely and quickly in various environmental conditions," according to a fact sheet released by the NTSB.

Helicopter crashes have resulted in almost 500 fatalities in the past decade, and many of these accidents involved air ambulances operating in stressful emergency situations. The NTSB recommends that emergency aircraft run flight risk evaluations before embarking on missions, especially those that involve adverse weather conditions. While some railroad companies have pushed back against the NTSB's safety recommendations, Hart reports that the helicopter industry seems far more enthusiastic. "The industry is not unaware of these problems," says Hart. "We're seeing a lot of push by the helicopter industry to move the deal forward."